Uninsured Uptowners Brace for Healthcare Budget Cuts

Oct. 22, 2008 – Uninsured and low-income residents of the Uptown neighborhood relying on free healthcare clinics are about to take another blow, as the Department of Public Health faces $8 million in lost revenue, according to the 2009 department budget released last Wednesday.

The Uptown Neighborhood Health Center, one of the city's largest free or reduced-fee health clinics, is located at 845 W. Wilson Ave. The clinic's future is bleaker when considering the 2009 city budget, proposed to the city council by Mayor Richard M. Daley on the same day as the department budget release.

"It's pretty grim," said Michael Crulcich, director of clinical operations for Chicago's Neighborhood Health Centers. "We're down to a lot bearer bones than we're used to."  

The Uptown clinic is one of seven city-funded health centers, all located in some of Chicago's poorest communities like Englewood and South Lawndale, facing major budget cuts.

According to Daley's proposed budget, likely to gain approval by the city council, the seven centers stand to shrink by over 35 percent, losing 60 of 167 current positions, including nurses and medical assistants.

Daley also recommends a 24 percent decrease in overall funding for these primary care clinics, which provide basic medical care, STD screening and vital pre-natal care to nearly 30,000 people annually, from $11.4 million down to $8.7 million.

For individual centers, like the one in Uptown, these cuts translate to longer waiting periods for patients to see doctors, sometimes exceeding three months for those with minor medical issues.

"When there's no one to take vital signs," Crulcich said of the decrease in medical assistants at the Uptown center, "the primary care provider must do it."

With only two full-time physicians assigned to the Uptown center, fewer patients will receive treatment each day.

"We're at 80 percent productivity," Crulcich said. That means where once a center could see 20 patients a day, that number is now reduced to 16, Crulcich said. 

The number of physicians has not been cut in the 26 years Crulcich has worked in the Department of Public Health. But there has been no effort, Crulcich said, to replace those who retired in the past 10 years. In recent years, the Uptown center had up to five physicians.

Lost doctors means a decrease in patients served, Crulcich said. And despite a decrease in affordable housing options and a subsequent decrease in the amount of poor residents in the area, this decrease "is not in response to gentrification," Crulcich said. "There's still a lot of need in Uptown."

Dr. Esther Liu agrees. "This is the largest and oldest center, and we see the most patients," said Liu, who has been at the Uptown center for three years.

Liu could not offer a specific number of patients served at the center overall, but said its WIC center, which offers nutritional counseling and food packages to low-income mothers, serves over 1600 clients each month. 

"We're very busy," Liu said.

The number of people living below the poverty line in Uptown is over 15,000, according to the 2000 city census, including over 2,500 families.

The proposed budget and personnel cuts for the Uptown Neighborhood Health Center come at a terrible time. Two weeks ago, the Salvation Army closed a major community center in Uptown, the Tom Seay Center, leaving the remaining social service agencies in the area scrambling to accommodate hundreds of newly displaced clients.

Still, Richard Sewell, chairman of Chicago Neighborhood Health Centers, is optimistic. "We're in full advocacy mode," Sewell said, pressing the Board of Health to pressure the city council and Mayor Daley to re-evaluate the 2009 budget before the council officially votes on it next month.